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Pharmacology 2nd Sem Prelim > Beta Lactam penicillin > Flashcards

Beta Lactam penicillin Flashcards

1
Q

The peptidoglycan is composed of glycan chains, which are linear strands of two alternating amino sugars

A

Nag Nam

N-acetylglucosamine and N-acetylmuramic acid

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2
Q

First stage of peptidoglycan biosynthesis

A

precursor formation
uridine diphosphate (UDP)acetylmuramyl-pentapeptide
Park neucleotide

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3
Q

Second stage of peptidoglycan biosynthesis

A

UDP-acetylmuramylpentapeptide and UDPacetylglucosamine

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4
Q

Third stage of biosynthesis of peptidoglycan

A

transpeptidation reaction

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5
Q

Last step in peptidoglycansynthesis

A

Inhibited by beta lactam antibiotics

By inhibiting the enzyme transpeptidase

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6
Q

Penicillins as well as cephalosporins are called beta-lactam antibiotics and are characterized by threefundamental structural requirements

A

Beta lactam structure
Carboxyl acid group
Amino acid side chains

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7
Q

The lactam structure can also be viewed as the covalent bonding of pieces of two amino acids

A

Cysteine and valine

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8
Q

The compound consists of 2 basic structures of penicillin

A

Thiazolidine Ring

2. Beta-Lactam Ring

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9
Q

the parent compound of all semisynthetic penicillins

A

6 amino penicillinic acid

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10
Q

Gram negative cocci

A

Moraxella catarrhalis
Neisseria gonorrheae
Neisseria meningitidis

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11
Q

Gram positive cocci

A 
Streptococcus pneumoniae 
Streptococcus, hemolytis (A,B,C,D) 
Streptococcus viridans 
Staphylococcus aureus 
Enteroccocus faecalis 
Enteroccocus faecium
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12
Q

Gram positive rods

A

Actinomycoses
Bacillus Clostridium
Corynebacterium diphtheriae/jeikeium
Listeria

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13
Q

Acid-‐fast rods

A

Mycobacterium

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14
Q

Spirochetes

A

Borrelia bugdorferi/recurrentis,
Leptospira,
Treponema pallidium/pertenue

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15
Q

Chlamydiae

A

psittaci,
trachomatis,
pneumoniae

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16
Q

Penicillin greatest activity with

A

gram-positive organisms,
gram negative cocci,
non-beta lactamase producing anaerobes

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17
Q

Penicillin little activity against

A

gram-negative rods

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18
Q

Pencillin Susceptible to destruction/hydrolysis by

A

Beta lactamase

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19
Q

Narrow spectrum penicillin

A 
Benzylpenicillin –Penicillin G 
•High activity against gram  (+) 
•Low activity against gram -
Phenoxymethyl penicillin-Penicillin V 
•Oral penicillin
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20
Q

Extended spectrum penicillin

A

Amino penicillins
Carboxy penicillin
Ureido penicillin

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21
Q

Aminopenicillins

A

Ampicillin

a. 2 Esters
a. 2.1. Bacampicillin
a. 2.2. Pivampicillin
a. 2.3. Talampicillin
a. 3. Amoxicillin

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22
Q

Carboxy penicillins

A 
Carbenicillin                   
b.1.1  Indanyl Carbenicillin     
b 1.2  Disodium Carbenicillin       
b.2     Ticarcillin 
b.3     Temocillin
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23
Q

Ureido penicillin

A

Mezlocillin

c. 2. Azlocillin
c. 3. Piperacillin
c. 4. Apalcillin

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24
Q

CARBOXYPENICILLINS and UREIDOPENICILLINS

A

Pseudomonas aeruginosa-‐

Bacteroides fragilis

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25
Q

Carboxypenicillins

A

Certain indole - proteus

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26
Q

Ureidopenicillins

A

Klebsiella

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27
Q

First antipseudomonal carboxypenicillin Obsolete: CHF, hypoK+, abnormal platelet aggregation

A

Carbenicillin

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28
Q

derivative use in UTI

A

Carbenicillin indanyl Na

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29
Q

Less active than ampicillin against enterococci

–Pseudomonas but inferior to piperacillin and mezlocillin

A

Ticarcillin

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30
Q

more active in Klebsiella; Pseudomonas; Enterococcus faecalis

A

Mezlocillin

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31
Q

Pseudomonas; Enterobacteriaceae; many Bacteroides

A

Piperacillin

32
Q

retain antibacterial spectrum of penicillin
•improved activity against gram (-) organisms
•destroyed by beta-lactamases

A

Ampicillin and Antipseudomonal Penicillins

33
Q

resistant to staphylococcal beta-lactamases active against staphylococci and streptococci inactive against enterococci & anaerobic bacteria, and gramnegative cocci & rods

A

Antistaphylococcal penicillins(Penicillinaseresistant

34
Q

Antistaphylococcal penicillins(Penicillinaseresistant

A

Methicillin (Staphcillin)
Nafcillin ( Unipen, Nafcil, Nallpen)
Isoxazolyl penicillins
a. Oxacillinb. Dicloxacillin c. Cloxacillind. Flucloxacillin

35
Q

resistant to staphylococcal beta-lactamases
•active to staphylococci and streptococci
•Not active against enterococci, anaerobic bacteria and gram –cocci and rods

A

Nafcillin

36
Q

not suitable for oral administration

A

Nafcillin

37
Q

Acid stable

A

Dicloxacillin,
Amoxicillin,
Ampicillin

38
Q

can inhibit transfer from CSF to blood stream (pen)

A

Probenecid

39
Q

biliary excretion

A

Nafcillin

40
Q

kidney & biliary excretion

A

Oxacillin,
dicloxacillin,
cloxacillin

41
Q

Repository preparation of pen G

A

penicillin Gprocaine (4 to 5 days)

penicillin G benzathine (26 days

42
Q

inadvisable particularly with benzylpenicillin as it can cause convulsions

A

Intratechal administration

43
Q

5-‐10x less active against gram (-‐) microbes, esp. Neisseria and certain anaerobes
better absorbed from the GIT

A

Pen V

44
Q

Pen V

A

oral form in minor infections
relative poor bioavailability;
dosing 4x a day Narrow antibacterial spectrum

45
Q

most active of the oral beta lactamsvspen resistant pneumococcistrains

A

Amoxicillin and ampicillin

46
Q

effective for shigellosis

A

Ampicillin

47
Q

Extended spectrum penicillin that have better absorption

A

Amoxicillin

48
Q

not used to treat uncomplicated salmonella gastroenteritis somewhat less active than Pen G vs gram (+) cocci enterococcal grp. D and viridans grp of streptococci Listeria monocytogenes H. influenza. And E. coli

A

Ampi and amoxicillin

49
Q

no longer used bec. of its nephrotoxicity

A

Methicillin

50
Q

Adverse effect

A

Hypersensitivity reactions
Gastrointestinal disturbances after oral administration
3. Convulsions following rapid IV injection
4. Accidental injection to sciatic nerve
5. Hepatitis

51
Q

pulmonary embolism
-acute psychotic reactions

AE

A

Procaine pen G after accidental injection

52
Q

hepatitis
-granulocytopenia, bone marrow depression

AE

A

Oxacillin and nafcillin

53
Q

Hypernatremia

AE

A

Disodium Carbenicillin and high dose Penicillin G Na

54
Q

hyperkalemia with high doses

AE

A

Pen G K

55
Q

Jarisch-Herxheimerreaction

AE

A

Pen G Na

56
Q

bleeding diathesis

AE

A

Carbenicillinand Ticarcillin

57
Q

interstitial nephritis

AE

A

Methicillin

58
Q

pseudomembranous colitis

AE

A

Ampicillin

59
Q

Penicillinsbindtoandinactivateaminoglycosides

A

Chemical antagonism

60
Q

Penicillin G and its close congener penicillin V are highly active against

A

gram-positive cocci, but they are readily hydrolyzed by penicillinase

61
Q

ineffective against most strains of Staphylococcus aureus

A

Pen G and Pen V

62
Q

The penicillinase-resistant penicillins (methicillin, nafcillin, oxacillin, cloxacillin, and dicloxacillin) have less potent antimicrobial activity against

A

microorganisms that are sensitive to penicillin G

effective against penicillinase-producing Staph. aureus

63
Q

Ampicillin, amoxicillin, bacampicillin, and others comprise a group of penicillins whose antimicrobial activity is extended to include such

A

gram-negative microorganisms as
Haemophilus influenzae,
E. coli, and
Proteus mirabilis

64
Q

DOC for meningitis; pneumococcal pneumonia and pneumococcal meningitis

A

Penicillin G (benzylpenicillin

65
Q

most penicillin-‐resistant pneumococci are resistant to

A

3rd generation cephalosporin

66
Q

Penicillin G -‐resistant to

A

S. aureus,
S. epidermidis,
Strep. viridans,
Corynebacterium diphtheria

67
Q

Endocarditis ( Strep. viridans

A

Procaine Pen G
Pen G plus
Streptomycin or gentamycin

68
Q

Enterococci endocarditis

A

Pen G + aminoglycosides

69
Q

Syphilis

A

Pen G procaine + probenecid

70
Q

Actinomycosis

A

Pen G + oral pen V

71
Q

Diphtheria (eliminate carrier

A

Pen G procaine injection (single)

72
Q

Gingivostomatitis

A

Pen V

73
Q

Anthrax
Clostridial
Erysipelas
Endocarditis

A

Pen G

74
Q

Lyme disease

A

Tetracycline

Amoxicillin

75
Q

heteropolymeric component of the cell wall that provides rigid mechanical stability by virtue of its highly cross-linked latticework structure

A

Peptidoglycan

Pharmacology 2nd Sem Prelim (7 decks)

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